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El-Sawy MA, Donia S, Elmowafy DA. Clinical and radiographic outcomes around 4 mandibular implant-retained overdentures in individuals with type 2 diabetes: A long-term retrospective study. J Dent 2024; 145:104982. [PMID: 38583644 DOI: 10.1016/j.jdent.2024.104982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/15/2024] [Accepted: 03/31/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES To report the implant survival rates, clinical, and radiographic status after a period of more than 5 years in the function of 4 inter-foraminal implants retaining mandibular overdentures (OVDs) in individuals with T2DM. METHODS 78 completely edentulous participants with type 2 diabetic mellitus (T2DM) who had worn mandibular OVDs retained by 4 inter-foraminal implants for long-term functional life were selected for this study. The participants were divided into 2 groups according to glycosylated haemoglobin A1c (HbA1c) levels before implant placement: group I with an HbA1c value > 6.5 % (inadequately controlled T2DM), and group II with an HbA1c value ≤6.5 % (well-controlled T2DM). The inadequately controlled T2DM was further subdivided into 2 groups: Group IA with an HbA1c value > 6.5 % and ≤8 % (moderately controlled), and Group IB has an HbA1c value > 8 % (poorly controlled). Implant survival rate, plaque index (PI), bleeding on probing (BOP), probing depth (PD), and radiographic crestal bone level (CBL) around implants were measured. RESULTS Among 312 implants, 6 failed, 4 in well-controlled diabetics, and 2 in inadequately controlled diabetics. The overall survival rate was 98.07 %. The mean PI in group Ι was 36.4 (group IA =37.76, group IB = 34.27), and in group ΙΙ it was 19. The mean BOP in group Ι was 45.5 (group IA =47.84, group IB = 41.76), and in group ΙΙ it was 22. The mean PD in group Ι was 4.1 (group IA =4.3, group IB = 3.85) and in group ΙΙ was 2.2. The mean radiographic CBL in group Ι was 3.4 (group IA =3.7, group IB = 2.9), and in group ΙΙ was 1.5. Group IA exhibited a significantly greater level of PI, BOP, PD, and CBL compared to group IB and group IΙ (P1=0.017, P2=0.001). CONCLUSIONS Individuals with T2DM can benefit from 4 inter-foraminal implants retained mandibular OVDs, and their inability to maintain proper glucose control may not exclude implant success. CLINICAL SIGNIFICANCE This study is a significant step toward improving knowledge of options available for treatment and anticipated outcomes for T2DM completely edentulous populations undergoing implant therapy.
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Affiliation(s)
- Mohammed A El-Sawy
- Department of Prosthetic Dental Science, Faculty of Dentistry, Menoufia University, Shebin El Kom, Egypt; Department of Prosthodontics, Faculty of Applied Dental Science, Menoufia University, Shebin El Kom, Egypt.
| | - Sherin Donia
- Department of Prosthetic Dental Science, Faculty of Dentistry, Menoufia University, Shebin El Kom, Egypt
| | - Doaa A Elmowafy
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Al-Dakahliya, Egypt
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Wajima CS, Pitol-Palin L, de Souza Batista FR, Dos Santos PH, Matsushita DH, Okamoto R. Morphological and biomechanical characterization of long bones and peri-implant bone repair in type 2 diabetic rats treated with resveratrol. Sci Rep 2024; 14:2860. [PMID: 38310154 PMCID: PMC10838324 DOI: 10.1038/s41598-024-53260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
Type 2 diabetes interferes with bone remodeling mechanisms, requiring studies to reverse this damage, and resveratrol is a polyphenol with rich properties. This study aimed to characterize the long bone morphology and peri-implant biomechanics of normoglycemic and type 2 diabetic animals treated with resveratrol. Thirty-two male Wistar rats were used and divided into normoglycemic and diabetic with or without treatment. They had the installation of implants in the tibia and treatment with oral resveratrol within 45 days. Resveratrol was responsible for weight homeostasis and decreased glycemic levels in rats with type 2 diabetes. The three-point bending testing, resveratrol showed positive effects on the biomechanics of long bones, corroborating a more resistant bone in comparison to untreated diabetics. Micro-ct revealed how bone metabolism is affected by systemic disease, decreasing bone quality. The counter-torque of normoglycemic animals showed superior osseointegration to diabetes, with no differences in the administration of the polyphenol, showing the sovereignty of the deleterious effects of the disease when there is a tissue lesion and an inflammatory picture installed. Overall, resveratrol acted positively in the etiopathogenesis of type 2 diabetes and revealed positive effects on the strength of long bones.
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Affiliation(s)
- Carolina Sayuri Wajima
- Department of Basic Science, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Letícia Pitol-Palin
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Fábio Roberto de Souza Batista
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Doris Hissako Matsushita
- Department of Basic Science, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Roberta Okamoto
- Department of Basic Science, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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Li Y, Lu Z, Sun H. Impact of diabetes mellitus on the poor prognosis in patients with osseointegrated dental implants: a meta-analysis of observational studies. Biotechnol Genet Eng Rev 2023:1-19. [PMID: 36876980 DOI: 10.1080/02648725.2023.2184922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/18/2023] [Indexed: 03/07/2023]
Abstract
This meta-analysis aimed to explore the correlation between diabetes mellitus (DM) and peri-implant diseases in patients with osseointegrated dental implants. Relevant studies were searched in multiple databases from the available date of inception through 26 August 2021. The odds ratios (ORs) were used as the effect indicator for measurement data, and each effect size was given estimates and 95% confidence intervals (CIs). Begg's test was used for publication bias. Twenty-one observational studies with 24,953 participants were selected. No significant association was shown between DM and peri-implant mucositis (OR: 0.739, 95% CI: 0.394-1.383, P = 0.344). The results demonstrated that the risk of peri-implantitis was higher in DM than in non-DM (OR: 1.553, 95% CI: 1.084-2.226, P = 0.016). Smokers had higher risk of peri-implantitis than non-smoking patients (OR: 1.754, 95% CI: 1.620-1.899, P < 0.001). In addition, no significant association was shown between DM and peri-implantitis among non-smokers. The association between periodontal history (OR: 2.538, 95% CI: 0.814-7.921, P = 0.109), poor plaque control (OR: 1.700, 95% CI: 0.334-8.648, P = 0.523) and peri-implantitis was not statistically significant. No publication bias was observed for each outcome. DM increases the risk of poor outcomes in osseointegrated dental implant patients. The findings of the present study further elucidate the need for longitudinal investigations regarding risk variables that affects peri-implant tissues.
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Affiliation(s)
- Yang Li
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhanyi Lu
- JiangBei Stomatological Center, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huachang Sun
- Stomatology Department, Jiangsu Provincial Hospital on Integration of Chinese and Western Medicine Jiangsu, NanJing, China
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Carra MC, Blanc-Sylvestre N, Courtet A, Bouchard P. Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36807599 DOI: 10.1111/jcpe.13790] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
AIM This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). MATERIALS AND METHODS A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. RESULTS Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I2 : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I2 : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. CONCLUSIONS Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.
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Affiliation(s)
- Maria Clotilde Carra
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,Population-Based Epidemiologic Cohorts Unit, Inserm, UMS 11, Villejuif, France
| | - Nicolas Blanc-Sylvestre
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,URP 2496, Université Paris Cité, Paris, France
| | - Alexandre Courtet
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France
| | - Philippe Bouchard
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,URP 2496, Université Paris Cité, Paris, France
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Liu Q, Yang J, Wang R, Yuan L, Yu K. Dental implant failure rates with low insertion torque with a nonsubmerged surgical approach: A retrospective clinical study. Clin Implant Dent Relat Res 2023; 25:118-123. [PMID: 36398387 DOI: 10.1111/cid.13159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND It is currently unclear if a low insertion torque (IT) should prompt a clinician to submerge the dental implant at time of placement. PURPOSE This study aimed to analyze implant failure rates and marginal bone loss (MBL) as a function of IT and surgical approach. MATERIALS AND METHODS A total of 197 patients who had received 295 Mozo Grau (MG) implants were included in this study. The healing of submerged or nonsubmerged implants was evaluated in regular IT (≥20-25 Ncm) or low IT (<20-25 Ncm) cases. Implant failure and MBL were evaluated before prosthesis placement and at 6 and 12 months after functional loading with generalized estimating equations. RESULTS The overall 12-month implant failure rate was 4.8% (95% confidence interval [CI]: 2.7%-8.2%). When successful at 12 months, dental implants placed with low IT and nonsubmerging had the same MBL as implants dental implants placed with other approaches (mean difference = -0.02 mm; 95% CI -0.05 to 0.02). Low IT combined with nonsubmerging of the dental implant was associated with a 30-fold increased odds for dental implant failure (95% CI: 3.8-236.6). CONCLUSION low IT and nonsubmerged healing was associated with a high failure rate.
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Affiliation(s)
- Qiqi Liu
- College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Jian Yang
- College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Ruibin Wang
- College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Lingling Yuan
- College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Ke Yu
- College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
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Sbricoli L, Bazzi E, Stellini E, Bacci C. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent J (Basel) 2022; 11:dj11010010. [PMID: 36661547 PMCID: PMC9857470 DOI: 10.3390/dj11010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.
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Wang Q, Xia Q, Meng M, Li Y, Tang Z, Zeng X, Chen H, Shu J, Xv X, Chen J, Lu J, Wang H, Ye Z, Song B, Dong Q. miR-153-3p inhibits osteogenic differentiation of BMSCs by down-regulating the expression of RUNX2 in a high glucose environment. Am J Transl Res 2022; 14:7027-7039. [PMID: 36398274 PMCID: PMC9641434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/07/2022] [Indexed: 06/16/2023]
Abstract
To study the effect of miR-153-3p on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in a high glucose environment and its potential mechanism. The results showed that high glucose inhibited the osteogenic differentiation of BMSCs, and the expression of miR-153-3p increased during osteogenic differentiation. Further experiments found that in BMSCs induced by high glucose, overexpression of miR-153-3p inhibited the osteogenic differentiation of BMSCs, and the expressions of osteogenesis-related genes bone sialoprotein, Collagen I and alkaline phosphatase were down-regulated, while silencing of miR-153-3p alleviated the inhibition effect. The dual-luciferase reporter gene assay confirmed that the 3'-untranslated region (3'-UTR) of runt related transcription factor 2 (RUNX2) had a targeted binding site with miR-153-3p and a negative regulatory effect. Molecular studies further confirmed that miR-153-3p inhibited the osteogenic differentiation of BMSCs by targeting the 3'-UTR of RUNX2. In conclusion, our study found that as one key regulator of high glucose affecting the osteogenic differentiation of BMSCs, miR-153-3p may play a negative regulatory role by inhibiting the expression of RUNX2.
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Affiliation(s)
- Qinying Wang
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Qian Xia
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Preventive and Pediatric Dentistry, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Maohua Meng
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Ying Li
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Zhenglong Tang
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Xiao Zeng
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Helin Chen
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Jiayu Shu
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Xingxing Xv
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Jingqiao Chen
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Jing Lu
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Huan Wang
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Zhaoyang Ye
- Clinical Research Center, The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
| | - Bin Song
- Department of Prosthodontics, Guizhou Provincial People’s HospitalGuiyang 550003, Guizhou Province, China
| | - Qiang Dong
- School of Stomatology, Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
- Department of Prosthodontics, Stomatological Hospital of Guizhou Medical UniversityGuiyang 550004, Guizhou Province, China
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Systematic review on diabetes mellitus and dental implants: an update. Int J Implant Dent 2022; 8:1. [PMID: 34978649 PMCID: PMC8724342 DOI: 10.1186/s40729-021-00399-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.
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Nourah D, Aldahlawi S, Andreana S. Should the Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on Implant Survival. Curr Diabetes Rev 2022; 18:e060821195367. [PMID: 34365929 DOI: 10.2174/1573399817666210806120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used is as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. AIM This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less than optimal glycemic control. DISCUSSION Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. CONCLUSION In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.
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Affiliation(s)
- Dalia Nourah
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Aldahlawi S, Nourah D, Andreana S. Should Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on: Peri-Implant Diseases. Clin Cosmet Investig Dent 2021; 13:149-154. [PMID: 33911902 PMCID: PMC8071690 DOI: 10.2147/ccide.s297467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/09/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND AIM Traditionally patients with metabolic conditions such as diabetes mellitus are considered not suitable candidates for dental implant therapy due to increased risk of infection, impaired bone healing or the potential for vascular complications. Peri-implantitis as the more progressive form of peri-implant disease involves bone loss and estimated to occur in nearly half of all implant cases long-term. Despite extensive research on association of hyperglycemia with dental implants in preclinical and animal models, translational effort to clinical practice is hampered by discrepancies in reported outcome indicators for peri-implantitis in patients with a spectrum of glycemic profiles. This review aims to evaluate clinical evidence for peri-implant disease in metabolically compromised patients and in particular in patients with poorly-controlled diabetes in order to inform clinical management of peri-implant disease. MATERIALS AND METHODS A comprehensive literature review was performed utilizing PubMed database and using the key word 'diabetes' combined with "dental implant" or "Periimplantitis" or/and "Preimplant disease". RESULTS Clinical studies with follow up more than 1year, systematic review and meta-analysis that evaluated peri-implant disease in diabetic patients in relation to glycemic control were taken into consideration in this review. CONCLUSION Studies reported conflicting results regarding the long-term effect of diabetes on peri-implant health regardless of the level glycemic control. Therefore, interpretation of finding and relevance to clinical practise should be considered on individual bases.
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Affiliation(s)
- Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Dalia Nourah
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Tan SJ, Baharin B, Nabil S, Mohd N, Zhu Y. DOES GLYCEMIC CONTROL HAVE A DOSE-RESPONSE RELATIONSHIP WITH IMPLANT OUTCOMES? A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 21:101543. [PMID: 34391557 DOI: 10.1016/j.jebdp.2021.101543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To comprehensively evaluate implant survival, clinical and biochemical parameters, as well as possible dose-response relationship with hemoglobin A1c (HbA1c) in patients with differing diabetic control. METHODOLOGY Five electronic databases were searched for studies that compared implant outcomes in patients with differing HbA1c values. Research quality was evaluated using Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Narrative synthesis and meta-analysis were performed for survival rate, plaque index (PI), bleeding on probing (BOP), probing pocket depth, and marginal bone loss (MBL). Categorical dose-response meta-analysis (DRMA) was conducted according to length of follow-up. RESULTS Twenty-two studies met the inclusion criteria. Prospective studies were mostly of moderate quality, but non-prospective papers had serious to critical risk of bias. Survival rate was high for the first 3 years (92.6%-100%) for patients with HbA1c less than 8%. Meta-analysis revealed worsening clinical parameters with increasing HbA1c. DRMA further established a significant dose-response relationship between glycemic control with BOP (10% more bleeding, 95% CI 0.05-0.16, P = .008) and MBL (0.05 mm more bone loss, 95% CI 0.01-0.09, P = .002) per HbA1c category, but no association with probing pocket depth. Osseointegration progressed at a slower rate, and inflammatory cytokines and bone biomarkers were adversely affected in patients with HbA1c above 8%. CONCLUSION Moderate evidence suggests a high short-term survival but possible dose-response trend of worsening BOP and MBL in association with glycemic control. Clinically, HbA1c values must be considered for risk assessment before placement and throughout the lifespan of the implant placed in a patient with diabetes.
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Affiliation(s)
- Sze Jun Tan
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Badiah Baharin
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Syed Nabil
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nurulhuda Mohd
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Yingying Zhu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Juncar RI, Precup AI, Juncar M. Immediate implant-prosthetic dental rehabilitation of patients with diabetes using four immediately loaded dental implants: a pilot study. J Int Med Res 2021; 48:300060519897195. [PMID: 32228306 PMCID: PMC7133089 DOI: 10.1177/0300060519897195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objectives Type 2 diabetes mellitus (T2DM) involves endocrine changes that cause a persistent increase in blood glucose. Many disorders are associated with T2DM, including disorders that affect the oral cavity. Oral cavity disorders interfere with a patient’s capacity to follow a correct diet, which results in worsening systemic disease. Oral rehabilitation is necessary for patients with T2DM. Therefore, this prospective study was performed to evaluate the immediate dental rehabilitation capacity of patients with T2DM using four immediately loaded dental implants. Methods In this prospective study, four implants each were placed in four patients with T2DM and loaded within 24 hours. Demographic characteristics were assessed at baseline; systemic and oral health parameters were assessed at baseline and at 6 months after implant placement. Results The mean glycated hemoglobin (HbA1c) level was 7.05% (range, 6.8%–7.3%). The mean Implant Stability Quotient of the dental implants was 74.5 (range, 67–85). Postoperative evolution was favorable: only one implant exhibited inflammation of the prosthetic stump. Conclusions Immediate prosthetic rehabilitation using four maxillary dental implants was an effective treatment modality for patients with T2DM in this study. Larger studies are needed to confirm these findings.
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Affiliation(s)
- Raluca-Iulia Juncar
- Department of Prosthetics, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Alexandru-Iosif Precup
- Oral and Maxillofacial Surgery, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Mihai Juncar
- Oral and Maxillofacial Surgery, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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Jiang X, Zhu Y, Liu Z, Tian Z, Zhu S. Association between diabetes and dental implant complications: a systematic review and meta-analysis. Acta Odontol Scand 2021; 79:9-18. [PMID: 32401121 DOI: 10.1080/00016357.2020.1761031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to explore the possible association between diabetes mellitus and dental implant complications. MATERIAL AND METHODS A systematic literature review was conducted to answer the following PICO (Participants, Intervention, Comparison, and Outcome) question: Is there association between diabetes mellitus and dental implant complications? Two independent searchers performed a literature search of the PubMed/MEDLINE, Web of Science, Cochrane Library and EMBASE databases for studies published until February 2020, focussing on studies including continuous outcomes, marginal bone loss (primary outcome), probing depth, and bleeding upon probing (secondary outcomes). RESULTS AND CONCLUSIONS A final total of 10 published studies were included in this systematic review. There were statistically significant differences between the groups with regard to marginal bone loss (p < .00001), probing depth (p < .00001) and bleeding around dental implants (p < .00001), and subjects without diabetes had lower complication rates. Additionally, in the subgroup analysis performed with loading time and HbA1c levels, a more evident association was found in immediate loading for probing depth. Moreover, the analysis results of bleeding around dental implants suggested that as HbA1c level increases, the bleeding of the tissues surrounding the implant will also increase. With regard to dental implant complications, there were statistically significant differences favouring patients without diabetes mellitus.
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Affiliation(s)
- Xue Jiang
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, P.R. China
| | - Yanlin Zhu
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, P.R. China
| | - Zhaoying Liu
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, P.R. China
| | - Zilu Tian
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, P.R. China
| | - Song Zhu
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, P.R. China
- Department of Prosthodontics, Hospital of stomatology, Jilin University, Changchun, Jilin, P.R. China
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Hultin K, Eriksson A, Backe C, Johansson U, Bougas K. A Pilot Study with Randomised Controlled Design Comparing TiZr Alloy Dental Implants to Ti Implants. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2020; 11:e3. [PMID: 33598111 PMCID: PMC7875101 DOI: 10.5037/jomr.2020.11403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
Objectives Evidence on the clinical performance of recently introduced dental implants in titanium-zirconium alloy is sparse. The aim of the present pilot study with randomized controlled design is to compare changes in supporting structures around dental titanium-zirconium alloy implants to commercially pure titanium implants. Material and Methods The present material includes consecutive patients referred to a specialist clinic in Sweden. Two patient groups treated with dental implants in two different materials - titanium (Ti) and titanium-zirconium (TiZr) - were defined after block randomisation for smoking. In total, 40 implants installed in 21 patients were available for one-year follow-up. Marginal bone level, soft tissue height and width of keratinised mucosa were registered at baseline and at one-year follow-up. Results At implant level, the test group (TiZr) yielded significant marginal bone loss (P < 0.001) after one year. Additionally, marginal bone loss after one year was significantly higher for TiZr implants (P < 0.001) as compared to traditional Ti implants. Soft tissue dimensions were stable throughout the evaluation time for both implant materials. Conclusions One-year results indicate more pronounced initial marginal bone loss for dental implants in titanium-zirconium alloy as compared to implants made of commercially pure titanium.
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Affiliation(s)
- Kristina Hultin
- Department of Prosthodontics, Södra Älvsborg Hospital, BoråsSweden
| | - Annelie Eriksson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Christina Backe
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Ulf Johansson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Kostas Bougas
- Department of Periodontology, Södra Älvsborg Hospital, BoråsSweden
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Wang X, Wang H, Zhang T, Cai L, Kong C, He J. Current Knowledge Regarding the Interaction Between Oral Bone Metabolic Disorders and Diabetes Mellitus. Front Endocrinol (Lausanne) 2020; 11:536. [PMID: 32903738 PMCID: PMC7438828 DOI: 10.3389/fendo.2020.00536] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 07/01/2020] [Indexed: 12/16/2022] Open
Abstract
Diabetes mellitus, a major chronic disease affecting human health, has been increasing in prevalence in recent years. Diabetes mellitus can cause bone metabolic disorders in patients, leading to osteoporosis, a higher risk of traumatic fracture, and other bone diseases. Bone metabolic disorders in the oral cavity principally manifest as periodontitis, loss of alveolar bone, and failure of implant osseointegration. In recent years, numerous studies have shown that there is a complex interaction between bone metabolic disorders and diabetes mellitus. This paper reviews the adverse effects of diabetes on oral bone metabolism disorders such as alveolar osteoporosis and bone loss in patients with periodontitis, discusses the potential mechanisms of diabetic bone loss, and suggests potential ways to prevent and treat oral bone loss in patients with diabetes mellitus.
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Affiliation(s)
- Xiaofeng Wang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
- Department of Pediatrics, Pediatric Research Institute, The University of Louisville School of Medicine, Louisville, KY, United States
| | - Huiyu Wang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Tianfu Zhang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Lu Cai
- Department of Pediatrics, Pediatric Research Institute, The University of Louisville School of Medicine, Louisville, KY, United States
- Departments of Radiation Oncology, Pharmacology, and Toxicology, University of Louisville, Louisville, KY, United States
| | - Chenfei Kong
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Chenfei Kong
| | - Jinting He
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
- Jinting He
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Chambrone L, Palma LF. Current status of dental implants survival and peri-implant bone loss in patients with uncontrolled type-2 diabetes mellitus. Curr Opin Endocrinol Diabetes Obes 2019; 26:219-222. [PMID: 31145131 DOI: 10.1097/med.0000000000000482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW The current review summarizes recent evidence on the impact of type-2 diabetes mellitus (T2DM) on implant dentistry, highlighting the behavior of peri-implant bone. RECENT FINDINGS There is no definitive information on the development and course of peri-implant bone loss associated with T2DM; however, poorly controlled T2DM patients present worse outcomes. Nevertheless, dental implants may be a successful therapy for these patients in a manner similar to healthy individuals, when glycemic levels and oral hygiene are strictly maintained. SUMMARY The most recent literature on the impact of T2DM on peri-implant bone loss was reviewed to evaluate the feasibility of dental implant therapy over the time for these patients.
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Affiliation(s)
- Leandro Chambrone
- MSc Dentistry Program, Ibirapuera University, São Paulo, São Paulo, Brazil
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogota, Colombia
| | - Luiz F Palma
- MSc Dentistry Program, Ibirapuera University, São Paulo, São Paulo, Brazil
- Division of Descriptive and Topographic Anatomy, Department of Morphology and Genetics, Federal University of São Paulo, São Paulo, São Paulo, Brazil
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Li W, Tong J, Li N, Liu P, Li Y, Wang S. A study on the relationships of inflammation, antioxidant ability and healing with blood glucose in elderly patients with type 2 diabetes mellitus after dental implantation. Panminerva Med 2019; 62:283-284. [PMID: 31290301 DOI: 10.23736/s0031-0808.19.03668-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Weiwei Li
- Department of Stomatology, Tangshan Gongren Hospital, Tangshan, China
| | - Jing Tong
- Department of Stomatology, Tangshan Gongren Hospital, Tangshan, China
| | - Na Li
- Department of Stomatology, Tangshan Gongren Hospital, Tangshan, China
| | - Peng Liu
- Department of Stomatology, Tangshan People's Hospital, Tangshan, China
| | - Yanhua Li
- Department of Stomatology, Zunhua People's Hospital, Zunhua, China
| | - Shuwei Wang
- Department of Respiration, Tangshan Gongren Hospital, Tangshan, China -
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